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Causes of cellulitis
- Break in protective skin barrier
- Bacteria enters, releases toxins into dermis and subcutaneous tissue
- Spreads through tissue spaces
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Clinical manifestations of cellulitis
- Acute onset of swelling
- “Localized” redness and pain
- Deep red erythema
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Systemic Signs of cellulitis
Fever, chills, sweating, tachycardia, hypotension
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In cellulitis what would you find tender and enlarged?
Regional lymph nodes
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What are some conditions that make older clients susceptible to cellulitis?
- Decreased resistance
- Malnutrition
- long term corticosteroid use
- malnutrition
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How is a mild case of cellulitis treated ?
on an outpt basis with oral Antibiotics
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How is a severe case of cellulitis treated?
IV antibiotics 7-14 days
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What would you teach a patient about the treatment of cellulitis?
- prevention of recurrent episode
- Antibiotic treatment compliance
- Use a warm, moist compresses to site every 2-4 hours
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What is psoriasis?
- Chronic, non-infectious
- erythematous skin disorder with inflammation
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What are characteristics of psoriasis?
- Occurs in patches
- Genetic systemic disease
- Characterized by remissions and exacerbations
- Cells pile up and form lesions instead of shedding
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What are causes of psoriasis?
- Epidermal trauma
- Streptococcal infections
- Genetics
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Clinical manifestations of psoriasis?
- Epidermis is thickened with extra skin cells
- Skin cells pile up
- bilateral symmetry common
- Dead cells create a white flaky layer of silvery white scales over a patch of inflamed skin
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What happens If scales are scraped away in psoriasis?
a dark red base of the lesion is seen
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What are the bleeding points seen in psoriasis?
- Commonly on elbows
- knees, scalp, genital and sacral areas
- palms, soles, and fingernails
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List some risk factors for psoriasis? (3)
- Stress
- Climate Changes
- Hormones
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Diagnostic testing for psoriasis?
Skin Biopsy
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What is the result of a positive skin biopsy for psoriasis?
Increased Serum uric acid levels
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How is psoriasis treated?
- Medical Management
- Suppress the immune system
- Retinoids
- Artificial UVL—photosensitizing
- Drugs to promote peeling
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Topical therapies for psoriasis
- Coal Tar (Anthralin)
- Corticosteroids
- Occlusive dressing: med to area, covered with plastic wrap
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Nursing Interventions for psoriasis
- Assist client with altered self concept
- Infection prevention from open lesions
- Keep lesions clean and dry
- Rx ointment and creams with occlusive dressings
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What is herpes zoster (HSV) / Shingles
- Acute Viral infection of nerve structure caused by Varicella Zoster
- Activation of dormant Varicella Zoster Virus
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What are some causes the herpes zoster/shingles?
- Chemo induced immunosuppression
- Hodgkin’s Lymphoma
- Debilitating Disease
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HSV/SHINGLES is related to the ___________.
chicken pox virus: Varicella
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Who is at risk of getting HSV/Shingles?
anyone who has NOT had chicken pox or who is immunosuppressed
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What does the HSV/Shingles look like?
- Linear patches of vesicles with an erythematous base
- Follows nerve pathway
- Spinal and cranial tracts
- Often unilateral, appears on trunk, can appear on face
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Assessment findings of HSV/Shingles
- Neuralgia
- Malaise
- Pruritis (itching) \Burning
- Erythema, clustered skin vesicles
- Fever
- Paresthesias often long term
- Skin culture reveals organism
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Where will the pain, burning & neuralgia occur with HSV/shingles?
At the site before the outbreak of vesicles
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How will you treat HSV/Shingles?
- Analgesics
- Cool compresses,
- Tepid baths
- Anti-anxiety agents
- Benadryl
- Zovirax, Interferon
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You will assess these for HSV/Shingles
- Assess pain levels, medicate, re-eval
- Neurovascular assessments
- Neurologic Status
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Candidiasis is a ___________ infection?
Fungal
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What type environment does Candidiasis like?
Warm, dark, moist environment
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What areas of the body are you more likely to see Candidiasis?
- skin folds
- groin area
- mouth
- vagina
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What does candidiasis look like?
- White, cottage cheese curds resemblance
- Check skin folds
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Causes of Candidiasis?
- Seen in immunosuppressed clients
- Overuse of Antibiotics
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Medical/Nursing Mgmt of candidiasis?
- Skin Hygiene…assess, assess. assess
- Keep folds dry, clean and open to air
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Drug treatments for Candidiasis?
- Nystatin
- anti-fungal powders or swish and swallows
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